Stephanie Polsinelli, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

5724 Issued in GA

Practice address

5730 Glenridge Dr Ste 100
Sandy Springs, GA 30328-5579

Phone

(404) 816-3000

Fax

(404) 946-0404

NPI assigned

Nov 24, 2009

Last updated

Apr 4, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/DABBDD

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Physicians Spine and Rehab Specialists of Ga

  • Specialist
  • Sandy Springs, GA
  • NPI 1710946322
  Medicare reassignment NPD
• Physicians Spine and Rehab Specialists of Ga

  • Durable Medical Equipment & Medical Supplies
  • Calhoun, GA
  • NPI 1972209864
  NPD
• Lawrenceville Family Practice

  • Health Maintenance Organization
  • Lawrenceville, GA
  • NPI 1831378249
  NPD (past)
• Peachtree Orthopaedic Clinic PA

  • Orthopaedic Surgery Physician
  • Atlanta, GA
  • NPI 1811912611
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1259020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712188800000",
    "number": "1780912071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5730 GLENRIDGE DR STE 100",
            "city": "SANDY SPRINGS",
            "state": "GA",
            "postal_code": "303285579",
            "telephone_number": "404-816-3000",
            "fax_number": "404-946-0404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5730 GLENRIDGE DR STE 100",
            "city": "SANDY SPRINGS",
            "state": "GA",
            "postal_code": "303285579",
            "telephone_number": "404-816-3000",
            "fax_number": "404-946-0404"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1730 Lawrenceville Suwanee Rd",
            "address_purpose": "LOCATION",
            "city": "Lawrenceville",
            "state": "GA",
            "postal_code": "300433507",
            "country_code": "US",
            "telephone_number": "770-338-0089 x241",
            "fax_number": "770-338-0091",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "18 Riverbend Dr SW Ste 100",
            "address_purpose": "LOCATION",
            "city": "Rome",
            "state": "GA",
            "postal_code": "301616019",
            "country_code": "US",
            "telephone_number": "706-314-1900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "790 Church St NE Ste 550",
            "address_purpose": "LOCATION",
            "city": "Marietta",
            "state": "GA",
            "postal_code": "300608958",
            "country_code": "US",
            "telephone_number": "404-816-3000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1035 Southcrest Dr Ste 250",
            "address_purpose": "LOCATION",
            "city": "Stockbridge",
            "state": "GA",
            "postal_code": "302816117",
            "country_code": "US",
            "telephone_number": "678-275-2200",
            "fax_number": "678-275-2201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POLSINELLI",
        "first_name": "STEPHANIE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-24",
        "last_updated": "2024-04-04",
        "certification_date": "2024-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "5724",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "5724",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Medical Physician Assistant in Sandy Springs, GA
• Providers in Sandy Springs, GA by specialty
• Medical Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.